Presentation
Young female presented with a headache and diplopia since a week.
Patient Data
On MR the signal intensity of brain parenchyma is normal.
No evidence of intracranial hemorrhage or no early signs of ischemia on DW images.
The posterior fossa appears unremarkable.
On T2 weighted images, there is a loss of vascular flow void in the intracranial segments of the left internal carotid artery.
CTA shows all segments of the left ICA were hypoplastic. The caliber of the left common carotid artery and the external carotid artery was smaller than right.
Axial CT images at the level of the skull base demonstrate the small and hypoplastic left carotid canal.
Case Discussion
Internal carotid artery (ICA) hypoplasia is extremely rare congenital anomaly. In most of cases ICA hypoplasia discovered incidentally and usually is asymphtomatic.
The most important radiologic landmark is the carotid canal. In ICA hypoplasia carotid canal presence but reduced in caliber, and in ICA aplasia is completely absent.
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